Does anyone have Aetna Health Insurance

heather.vasquez · 07-27-2008, 03:21 PM

I have Aetna POS Health Insurance and I was wondering how long it takes after all your pre-requisites are done? They don't cover Dieticians and the bills for the surgery and test are becoming qwite expensive. Any info would be great.:confused2:

KDjess · 07-27-2008, 04:00 PM

Hi - I am on Aetna and they paid for my 6 month weight management pre-cert and I just had my surgery on July 25th. My hospital and Doc require an overnight stay for all band patients (which actually worked out well) and the cost for the procedure and stay at the hospital was my $240 co-pay.

LadyWinsAll · 07-27-2008, 05:58 PM

I have Aetna insurance also. I will be banded on July 31. They did not cover the Psych eval nor the Nutritionist visit but they are covering the surgery in total and one overnight stay. I did my Eval on April 18, Nutritionist and Surgeon consult on June 30. All my paperwork was finally submitted on June 27. I was approved the following week. I could have had my surgery earlier but because of work conflicts I had to wait until July 31.

On pre-op liquids with 4 days to go.

heather.vasquez · 07-27-2008, 06:55 PM

Hi there thanks everyone I Started @ the end of April and I meet with the Dietician every 2 weeks. I've had most of my appt's. Just need to do a few more things to get my date!!! Good luck on your surgery.

Tess415 · 07-27-2008, 07:14 PM

I have Aetna and I went to the free seminar for LAP-BAND^® Aug 2007 and my actual surgery wasn't until March 2008. I am a nurse and had a pretty easy time navigating through all of the hoops. It can be very frustrating at times, you just need to hang in there.

Aetna is my secondary insurance thru my DH. My insurance has no coverage for WLS. However, all of the pre-op testing was covered by my insurance with the usual co-pays. Then Aetna picked up the customary balances minus my co-pays. (Dieticians were not covered, but I had a dear friend who is a Registered Dietician and she did my referral and follow up prior to surgery)

There was a 3 month high intensity MD supervised weight loss period or a 6 month weight loss period with less hoops to hop thru; but I did the 3 month plan and my LAP-BAND^® MD did the 3 month documentation for $25 a month and sent it into Aetna.

In the end, all I have to pay is 90% up to a max of $2000 for the year...I thought that was great!! My entire hospital bill cost me $1061 and $161 for each surgeon so far.

If I can give you one piece of advice that would be to get an actual person in charge of your case at Aetna to be able to contact and ask questions, it really helped me to have a name/number of someone on that end especially as I was waiting for final approval!! As it turned out, this very person had gastric bypass a couple of years ago and was very sympathetic and supportive in my cause!!!!

I wish you good luck and good health!!!!!

heather.vasquez · 07-27-2008, 07:26 PM

Thanks Tess !! I still have a few more test to go through do you think there is someone in charge of my case now? Or should I wait until all is said and done and they submit to the insurance co for final approval?

moonandstarzz · 07-27-2008, 07:42 PM

i have aetna and im having surgery aug 13, just a hint the policy stated that only need psych eval if you have had past issues, under the care or on meds for psych issues, they was trying to demand me to get one done even though policy stated otherwise. i did finally get my approval without but it took me a month extra to get it. so keep a eye on it.

jessicadyan7 · 07-27-2008, 08:43 PM

After my doc submitted my paper work, it took about two weeks for Aetna to approve my surgery.

Oh, I just thought of something else... if your doctor would refer you it might cover your dietitian as well as the nutritionist. just a thought.

Tess415 · 07-27-2008, 10:31 PM

Quote:

Originally Posted by heather.vasquez

Thanks Tess !! I still have a few more test to go through do you think there is someone in charge of my case now? Or should I wait until all is said and done and they submit to the insurance co for final approval?

I talked to the human resource person at my husbands employer and got the name of the person at Aetna that handles all of the accounts for his company. I contacted them after the paperwork went in. I found if you call the number on the card you get any Tom, Dick or Harry

and they don't look far enough into the computer to answer most questions especially if you get denied on the first try, or want to really make sure you are approved as a double check before your actual surgery.